For Cancer Patients, The Right Clinical Trial Can Be the Secret To Survival

I recently received several desperate pleas from readers asking how to get into a clinical trial I wrote about some months ago. The trial is for Lucanix, a very promising treatment for advanced non-small-cell lung cancer (NSCLC). This type of cancer, once advanced to stage III or IV, spreads aggressively to bones, liver, and other areas of the body. Many of the treatment options available work for awhile, then stop working, so patients and their loved ones are understandably desperate to find additional options.

Here's what they need to know: The company that makes Lucanix, NovaRx has started an international Phase III clinical trial to be held at 90 different clinical sites in the U.S., Canada, India, and Europe. The trial started in August 2008, which is when I first wrote about it, but it's ongoing and you can still get into it.

Lucanix isn't a cure; NSCLC at this stage isn't curable. But on average those taking Lucanix quadrupled the amount of time they had left; The 50 patients who were in the Phase II trial for Lucanix with stable disease following chemotherapy lived more than 44 months, compared with less than 10 to 12 months for those receiving standard treatment.

Ask these cancer patients or their family members what they'd do to get three extra years, and the answer will be clear: a lot. Families routinely drive hundreds of miles to access trials at faraway treatment centers; some even move to a distant city or another state in order to get the care they want.

At the moment, the clinical trials database lists 40 locations where the vaccine is available, but only 20 are in the U.S. Luckily, they're spread widely all over the country, from both Mayo clinics in Minnesota and Arizona to a number of University medical centers such as UC San Diego and Rush University in Illinois, to private cancer centers in Texas, South Carolina, and Oklahoma.

One thing to keep in mind, though; this is a double-blind, placebo-controlled trial, which means that half the patients enrolled in the trial won't actually get Lucanix; they'll get an injection containing an inactive solution. Unfortunately, it isn't possible to simply go to a doctor and get Lucanix, as it hasn't been approved by the FDA yet. (That's what the trial is for.) So it's a take-your-chances situation, which is not what anyone wants to hear. The trial also has many exclusions, including patients who've had multiple rounds of chemotherapy. Lung cancer patients have been discussing the pros and cons of treatments like Lucanix on the Lung Cancer Alliance Survivors Support Community if you'd like to join the discussion.

But this information about Lucanix has applications for others in Cancer World as well. There are many more of you out there, searching and hoping for a cure for other types and stages of cancer. And there may be hope like this out there for you, too.

A good place to start is with your oncologist or surgeon; ask if she's aware of clinical trials that would be appropriate. But don't take the doctor's answer as the final word -- even cancer specialists don't always know about the vast number of trials ongoing at any time, and they can also be reluctant to give up on the standard of care they've prescribed, even when it isn't proving to be as effective as hoped.

Go to the government's clinical trials database, and type in a few search terms, such as the type of cancer, the stage, and any other criteria that may apply. For example, with breast cancer you might put in if it's estrogen receptor positive (ER+) or negative, or you might put in the word surgery if treatment has already included surgery. Play around with different combinations of terms and see what comes up, then look at the criteria listed at the beginning of each trial to see if you or a loved one fits within the parameters required.

In many cases, patients have had good luck doing this process in reverse; looking up the clinical trials first, printing out the relevant ones, and then bringing the printouts to show the oncologist or surgeon. This way, there are concrete options to discuss rather than just the concept of enrolling in a trial. Since the criteria for admission are often complex and specific, your doctor can go over them with you and help you figure out which trials are realistic possibilities.

Good luck to all as we search for hope--and time. If you find something that works, please do come back and share the good word.

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